HomeMy WebLinkAboutPlumbing 16-0089 DATE TIME
CITY OF PRIOR LAKE n�,I r
INSPECTION NOTICE SCHEDULED oC `Ll/
ADDRESS Lf No I r
OWNER CONTR. // q.
PHONE NO. PERMIT NO. 't (.O -'8
❑ FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
❑ FOUNDATION 0 MECH RI 0 COMPLAINT
❑ FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
❑ INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
❑ FINAL 0 PLUMBING FINAL 0 GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FINAL 0
COMMENTS: Eh)akr 14ect,k-er
1.3 at, 2cA vuzs-
et '5-e-A4\--e-
WORK SATISFACTORY,PROCEED
❑ CORRECT ACTION AND PROCEED
❑ CORRECT WORK,C L R REINSPECTION BEFORE COVERING
Inspector. Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&SAFETY!
INSNOTI
(Co))
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT 2. . 2-i.Blue File.GoldPERMIT NO. //
3
3. YellowAiry Applicant I c
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
/ ) O ESU (161G lard &reit L4/1 174,
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PH)
O(WaNB)R 1144
I Q y I (Phone)
V q
(Address) -z{i Q v L/V X 16(0 r2
APPLICANT A nn
Name) �
C � U
YS o 4 i(i (Phone) �.�y.�q
is(Address) 1 /' P.ilu-':° `
1,35 6oLo^v 1.{'1(Qb4Address) MC Lf 1'r^'tS (City) Ove (Zip Code), 0.ry
Contact Person) AUCl " (Phone)657- P16-�'l E1/4/1
1 APPLICANT SIGNATURE . e./ L DATE
APP ICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain x Water Softener
Lavatory(Bathroom Sink) Stand Pipe(Washing Machine)
Laundry Tray(1 or 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet(Toilet) Other
FEE SCHEDULE
Industrial,Commercial&Multi-family 1%of job cost with a$49.50 minimum Residential,New One&Two-Family $149.50
Residential,Additions&Alterations $49.50
Estimated Cost $ Building Permit# The Minnesota Statutes §326.E5.14U
�� :; '..JRCHARGE"has been extended
PLUMBING PERMIT FEE $ `i-
STATE SURCHARGE $ / ' C.2?) he minim x.zm surcharge for a
TOTAL PERMIT FEE $ "fixed fee"permit is $ar,
(Office Use Only) .50 ) -- '
This Application Becomes Your Building Permit When Approved Paid so, 57 Receipt No. i_eye
Date Z•- 2-,7
& By �� %r-�---
Building Official Date
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372